Counterfeit and expired medicines sold on Sudan markets

Sudan’s National Council for Drugs and Toxins issued a warning last week regarding the unknown packaging of Amidol 500 mg tablets used as a painkiller. This warning redrew attention to the situation of pharmaceuticals in war-torn Sudan. As the continuing battles have led to the nearly complete cessation of the local industry, smuggled and counterfeit medicines are being sold on markets in various parts of the country.

With the destruction or suspension of pharmaceutical factories and the decline in the supervisory role of the Ministry of Health, the de facto government in Port Sudan is facing great difficulties in providing funding for the import of medicine. The country’s medication needs are estimated at about $300 million annually.

The closure of two-thirds of hospitals and health centres and the looting of thousands of pharmacies since the war between the Sudanese Armed Forces and the Rapid Support Forces erupted in April last year, have paralysed traditional channels of medicine distribution and created uncontrolled, parallel channels.

In early August last year, the Sudanese Pharmacists Association reported that 41 pharmaceutical companies in Khartoum state were plundered and damaged by RSF soldiers. About 50 per cent of the medicine factories in Khartoum were also damaged.

Yousuf Shakak, head of the Sudanese Pharmaceutical Importers Group, recalls that there were initially 21 pharmaceutical factories operating before April 15, 2023. “However this rapidly changed come the attack on Khartoum, which forced all production to cease,” he told Radio Dabanga yesterday.

“The halted production of more than 200 locally manufactured medicines created a large gap in the available medicines, from painkillers to treatment of chronic diseases such as high blood pressure and diabetes.”

Imported

The pharmacist also said that this gap in production for the first five months after the outbreak of the war, prompted factories to restart their productions abroad; manufacturing medicines outside Sudan with contracts in India and Egypt. These medicines were imported into Sudan from October and November onward.

At the same time, counterfeit medicines flooded the Sudanese markets in large quantities, as dealers exploited the trademarks of Sudanese factories to produce counterfeit medicines, packaged similarly to well-known brands but with unknown ingredients.

“However, since the import of legitimate medicines, the sale of counterfeit medicines has decreased to some extent,” Shakak said.

In January, the Ministry of Finance in Port Sudan decided to impose heavier custom fees, which also affected the import of medicines. The total costs of life-saving medicines has reportedly increased by more than 12 per cent due to the increased fees.

Fatima El Safi, a resident of Omdurman, complained to Radio Dabanga last week that medicines are too expensive to obtain.

“A strip containing 10 tablets against stomach problems for instance costs SDG3,000, while we pay SDG5,000 for a blood test in the laboratory that now re-opened in the neighbourhood. Most people have almost depleted their reserves and are spending their last money on food.”

Smuggled

Mohamed Hussein in Zalingei, capital of Central Darfur, also noted that the prices of these medicines are expensive and exceed the average person’s ability to buy them.

“The problem of obtaining well-preserved medicine is prevalent. All medicines on the market here are smuggled via Chad from other countries in West Africa,” he explained.

“Many medicines should be stored in appropriate conditions, such as low temperatures and protection from sunlight. The smuggled medicines, however, are sold outside legal and certified channels such as pharmacies, health centres, and hospitals, and have lost much, if not all validity.”